Duty hour restrictions: organizational dynamics, systems issues, and the impact on faculty.

Glen Bandiera,Melissa Kennedy Hynes,Salvatore M Spadafora

doi:10.1186/1472-6920-14-s1-s5

Glen Bandiera, Melissa Kennedy Hynes + Show 1 more

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https://doi.org/10.1186/1472-6920-14-s1-s5

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Abstract

The potential impact of resident duty hour restrictions on faculty is likely significant; however, the extent of this impact has still not been well documented. We undertook a narrative review of the literature to determine the magnitude of that potential impact and the nature of the evolving discourse related to faculty members as individuals. The literature provides an inconsistent picture of the impact of duty hour restrictions on faculty. While some studies have reported a significant increase in faculty workload, others suggest that the impact of duty hour restrictions has been minimal. Some papers suggest that duty hour restrictions may fundamentally change the nature of resident–teacher interactions and, as a result, will necessitate significant changes to the way education is delivered. Overall, the majority of issues of concern relate to one of the following: volume and composition of work, impact on faculty career choice, evolving perceptions of residents as learners, and the need to find an appropriate balance between learning and the quality and quantity of patient care. In describing these themes we identify some potential solutions and future directions for reconciling duty hour restrictions with faculty perceptions, anxieties, and desired outcomes.

Highlights

The body of literature on resident duty hour restrictions has neither systematically nor extensively dealt with the potential impact of these restrictions on faculty
We undertook a narrative review of the literature to determine the magnitude of that potential impact and the nature of the evolving discourse related to faculty members as individuals
The majority of issues of concern relate to one of the following: volume and composition of work, impact on faculty career choice, evolving perceptions of residents as learners, and the need to find an appropriate balance between learning and the quality and quantity of patient care

Summary

Introduction

The body of literature on resident duty hour restrictions has neither systematically nor extensively dealt with the potential impact of these restrictions on faculty. The 1984 death of Libby Zion is remembered by many as the impetus for the 2003 US duty hour restrictions, but it brought about a new imperative for faculty to provide closer and more attentive supervision of residents [1]. The 2010 National Physician Survey in Canada confirmed that physicians in practice are working long hours [2]. In this survey, practising specialists reported working a mean of 53 hours per week exclusive of call. The majority of practising specialists reported the need to continue professional duties immediately following the completion of long shifts.

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